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Submitter Enrollment Information Medicare Advantage & Part D Communications Handbook Approved Network Service Vendors
• Medicare Advantage Encounter Data and RAPS Data
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• Prescription Drug Event Data
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CSSC Operations / Prescription Drug Event Data / Enroll to Submit PDE / PDE Certification / PDE Certification...

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PDE Certification Letter

Certification of prescription Drug Event (PDE) Data

In order for Prescription Drug Event (PDE) data to be accepted by the production Prescription Drug Front end Processing System (PDFS) and the Drug Data Processing System (DDPS); the Submitter and associated plans must successfully pass the PDE Certification process.

The testing will include transmission/communications, format and content. There will be a two phased approach to this testing. The PDFS will be the preliminary test for transmission and format. The secondary test (DDPS) will fully examine the content of the PDE records to ensure they pass format and logical edits at the detail PDE record level.

PDE Test data must be submitted from the same automated system that will be used to submit production PDE data. If any major system changes are made to your processing or submission system, the PDE data will have to be re-certified. All MA-PD / PDPs must be certified to submit or must be registered with a certified submitter by January 31st of the contract year.

Certification Steps:

1. Complete the EDI Agreement and Submitter Application completely. Return to CMS/Palmetto GBA. A Submitter ID will be assigned to your organization.
2. Each Submitter should assign one or more Contract IDs and Prescription Benefit Package (PBP) IDs to the test file(s). Contact Palmetto GBA to schedule and coordinate your PDE testing and certification.
3. Prepare a PDE test file (with a minimum of 100 PDE records and a maximum of 5000 PDE records) using the automated system that will be used to submit production PDEs. The PDE test file submitted should contain a representative sample of Medicare Part D beneficiaries.
4. Response and Error reports will be returned to the Submitter for review and revision of any errors encountered during PDE testing. Resubmit as necessary until all mandatory field errors are satisfactorily resolved. Informational messages will not prevent the Submitter from completing the required PDE data certification.
5. Delete at least one of the previously accepted records.
6. Once the testing & certification of the PDE transmission is completed successfully, a one-time, volume test in the production region can be requested by the submitter, if desired.
7. As each PBP schedules and completes their testing and certification, CSSC Operations will maintain an automated record of those plans that are ready for PDE production processing.

All reference material is available on the CSSC web site. We encourage you to visit the site and register for e-mail notification of all updates. Please contact the CSSC Help Line with any questions regarding the guidelines provided herein, using the following contact information.

CSSC Operations AG-570
2300 Springdale Drive, Bldg One
Camden, SC 29020
http://www.csscoperations.com/
Phone: 1-877-534-2772